Healthcare: What are Idaho’s Republican leaders afraid of?

by Judy Ferro

Wednesday Gov. Otter came through for Idaho by calling the legislature back to Boise to pass legislation the Federal government requires before we can use its system for collecting child support from parents out of state and out of country.

That’s great, but not awesome.

Awesome would be adding Medicaid expansion to the agenda; by Idaho’s constitution, only the Governor can do that. You’d think he’d want to have 80.000 more Idahoans with insurance coverage, 450 fewer Idahoans dying each year, and $50 million tax dollars saved.

So what is Otter—and legislative leaders who kept expansion off the regular session agenda– afraid of?

Not the majority of Idahoans.   A January survey by Dan Jones & Associates found that 61% of Idahoans—including 53% of Republicans—support expanding Medicaid. Expansion is only fair. Is it right that non-workers have free insurance, while poorly paid workers don’t? Do we really want people to quit work because they develop diabetes? (Disclosure: Ferro’s Appliance laid our shop technician off after his second hospitalization with diabetes. Our cost to insure him would have been $700 a month. He got cheaper group insurance by working for a Boise hospital. That option isn’t open to everyone.)

Not health care entities.  In spite of all the paperwork and non-allowed charges, doctors like health insurance. They’d rather people with chest pain get to a hospital rather than wait to see if it goes away. They’d rather discover diabetes during a scheduled exam rather than during a life-and-death episode in the emergency room. And hospitals and surgery centers like to know that they are going to be paid even if the bill doesn’t rise enough to qualify for county indigent care.

Not the cost. The Federal government is providing 100% of the cost of covering low-paid workers through 2016 and, after tapering down, 90% after 2020.   Idaho state and counties would save millions of tax dollars now going for indigent care. The ripple effect from new money in the health care sector would boost Idaho’s economy about $24 million annually.

Can the national government afford it? Saving Idaho lives and giving its economy a shot in the arm will benefit the country a lot more than continuing multi-billion subsidies to the oil industry or tax breaks for companies moving jobs overseas. Until the Congress cuts those billions, members aren’t really more worried about their donors than about the national economy.

Can the economy afford it? Actually, we are now seeing the lowest per capita growth in healthcare costs in decades. The rates from 2009 to 2013 (the most recent in government reports) have stayed between 3.8 and 4.1%. Rates from 2001-2008 varied between 6.3 and 9.6%. Treating ailments early helps, as does allowing insurance companies to negotiate accepted prices.

Not a lack of bills or votes. Two or three bills were in the works during the 2015 legislature, though none were published. Still, supporters believe they had the votes to pass the House and, perhaps, the Senate.

What else is holding the bill back?

The rift in the Republican Party?  I don’t think it’s biased to note that there is a serious riff between Republican moderates and extremists. Extremists seem to control much of the party organization, while moderates have greater control in the legislature.

Each Republican moderate who voted for Medicaid expansion would become a target for primary opponents, and, unfortunately, a lot of Republican moderates don’t—and independents can’t—vote in Republican primaries.

By supporting Medicaid expansion, the current Republican legislative leaders could lose power to a group they fear far more than Democrats.

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